Aphakic Glaucoma

In contrast to primary congenital glaucoma, some standard techniques, including filtering surgery with antimetabolites [6, 38] or gonio-surgery [56], reveal unsatisfactory results in aphakic glaucoma in children. Acceptable long-term results have been reported - albeit with a considerable rate of postoperative complications - for glaucoma implant surgery [12] and with temporarily limited success for cyclodiode laser treatment [32].

A recent study has raised the question of whether delayed surgery in congenital cataract might reduce the risk of glaucoma. In this retrospective analysis, early cataract surgery during the 1st month of life increased the 5-year risk of secondary glaucoma (50%) compared to those eyes that underwent cataract surgery later (15%). Corrected visual acuity did not differ between eyes operated before and after 1 month of age. The 5-year risk of glaucoma in at least one eye was 25% following bilateral limbal lensectomy, with anterior vitrectomy remaining at a constant level for the first 5 years [55]. From these data, glaucoma risk in modern surgery of congenital cataract by a limbal approach must still be considered relatively high.

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